Going to the Beach With Psoriasis: Risks and Benefits

Skin conditions are incredibly common and can affect up to one in three Americans at any given time. While acne, eczema and dermatitis are the conditions with the highest rates among US adults, Psoriasis also ranks highly.

Psoriasis is an immune-mediated disease causing dry, scaly and usually red patches of skin due to systemic inflammation. Sometimes, these irritations are covered in silver scales and can cause soreness or itching, often uncomfortable, painful, and sometimes a knock to self-esteem.

Mild cases of psoriasis are usually treated with topical creams and ointments prescribed by a doctor or dermatologist. However, in cases where these are not effective, stronger ingestible medicines are taken, or else a patient might undergo light treatment, also known as phototherapy.

Beyond these treatments, research has found that natural sunlight can effectively treat or reduce the symptoms of psoriasis. For some with the condition, this means that measured exposure to sunlight or visiting the beach in the summer can have beneficial medical advantages – if the necessary precautions outlined below are taken.

What is Psoriasis caused by and how to identify it 

It is believed that psoriasis comes from a dysfunction of the immune system, which either causes the body to create too many skin cells or causes infection-fighting cells to erroneously attack healthy skin cells. 

Although the causes of psoriasis are not fully understood by researchers, it is believed that environmental factors and genetics can play a role in causing the condition, which is not contagious (1. Mayo Clinic). “Psoriasis has a strong genetic link and if both parents have it, the child has a 50% chance of having it," says Julie Moore, M.D., a dermatologist at Gottlieb Memorial Hospital. "If one parent has it, the child has a 10% chance of having psoriasis” (2. Science Daily).

Patches of psoriasis can appear anywhere on the body, including the scalp, base of the feet and under fingernails and toenails. There are several types of psoriasis; those suffering from the skin condition may occasionally discover one type to change into another, or suffer two types at once. Often, psoriasis appears in cycles, causing problems and then ceasing for the patient for a period. This may be to do with factors like diet or stress or time of year.

Overall, studies show that psoriasis affects 1-3% of the US population – meaning that approximately 7.5 million Americans currently suffer from psoriasis. For many of these patients, sunlight is a natural and cost-effective treatment for psoriasis.

​​Psoriasis and the sun: what you need to know 

According to researchers, sunlight in the summer months or in a warmer climate can effectively help to improve the skin's appearance for those with psoriasis (3. National Psoriasis Foundation).

Various studies have found that heliotherapy – also known as the use of natural sunlight for the treatment of certain skin conditions – was effective in reducing psoriasis symptoms. For some people, the red and silver scaly patches may disappear altogether, if sun exposure is effectively spread over time. In one study, exposing twenty patients with moderate to severe psoriasis in Gran Canaria, Canary Islands, to controlled sun exposure, found that “UV irradiation is a potent inducer of immunosuppression.” (4. Br J Dermatol. 2011).

However, while sunlight has been an effective treatment for psoriasis, experts from the American Association of Dermatologists advise consulting your GP beforehand and that a person should only use sun exposure treatment under professional medical advice.

Sunlight contains two treatments for psoriasis: UVB rays and vitamin D. Below, we’ve outlined their benefits.

What the experts say: UVB rays and psoriasis

The sun emits ultraviolet (UV) rays of two types: UVA or UVB – the difference is in the size of the wavelength, UVA is longer and leads to long-term effects like ageing, while UVB is shorter and leads to sunburn.

Experts have found that UVB rays – with the right amount of exposure – may help treat psoriasis by slowing rapidly growing skin cells, reducing inflammation, and reducing itching (5. AAD). The UVB present in natural sunlight penetrates the skin to slow down skin cell growth in the symptoms of psoriasis, even if only temporarily, making it a useful treatment.

However, sunlight is generally found to be less effective for the treatment of psoriasis than prescription phototherapy, which refers to a well-established UV light therapy treatment for psoriasis that involvescontrolled exposure to these rays, usually provided in a dermatologist’s office.

What the experts say: vitamin D and psoriasis

Sunlight helps the body create vitamin D, providing us with a significant portion of our required vitamin D supply along with our diets. A 2017 review discovered that vitamin D deficiency may be common among people with psoriasis (7.) For this reason, topical vitamin D ointments are often used by psoriasis surfers to counteract the abnormally fast regeneration of skin cells that leads to psoriasis plaques. “​Due to its role in proliferation and maturation of keratinocytes, vitamin D has become an important local therapeutic option in the treatment of psoriasis,” explain researchers. Yet, vitamin D’s role in psoriasis management has been contested as it’s unclear as to whether increased vitamin D actually improves psoriasis symptoms or whether the improvement is instead due to sunlight’s benefits to the immune system. (8. Rev EndocrMetabDisord. 2017).

How long should I sit in the sun with psoriasis?

Research suggests that around 30 minutes of exposure to the sun around noon could be a good place to start for those with mild cases of psoriasis. People with more severe symptoms may want to start with less time per day and increase their exposure time gradually over a series of weeks. The Environmental Protection Agency suggests that the sun’s rays are typically strongest between 10 am to 4 pm meaning it is critical to wear SPF while in the sun at this time in order to prevent photodamage and reduce risks (8. EPA)

The risks of UVF exposure for psoriasis

While a visit to the beach can have benefits to those with psoriasis then, there are risks to sun exposure without SPF. On a basic level, a severe case of sunburn could cause a bad psoriasis flare-up. Additionally, fjst as with any skin type – condition or no condition – the sun’s UV rays can cause severe sunburn as well as posing long term risks such as skin cancer.

Yet there are also specific ways in which patients with psoriasis might find themselves at increased risk. Some psoriasis medications such as acitretin or methotrexate can potentially increase sun sensitivity, while other medications such as those that block tumour necrosis factor alpha may also be at higher risk of contracting skin cancer.

Furthermore, patients who have undergone UVB exposure in the form of phototherapy should avoid sun exposure, including those who use PUVA, a light therapy that involves a combination of UVA rays and a drug called psoralen. This is because phototherapy can increase the risk of developing a melanoma through exposure of light treatment therapies. In a review article published in October 2019 in JAMA Dermatology, it was found that people with psoriasis who receive light therapy also have an increased risk of basal cell and squamous cell carcinoma (9. Life (Basel) 2021).

Finally, patients with psoriasis should categorically avoid tanning beds which contain wavelengths that can cause skin damage and increase the risks of skin cancer due to the fact that often use more UVA than UVB light.

Why SPF protection is so important 

An SPF refers to a scientific measure, giving an idea of how much lower the risk of skin damage is due to the use of the sunscreen based on the amount of time that it takes for UVB rays to get through a sunscreen and cause the skin to go red, compared with the time this takes without sunscreen. The factor is calculated by dividing the sun radiation dose needed to cause skin reddening with the dose needed to cause reddening without sunscreen.” (10. Medical News.)

For patients to experience the benefits of sun exposure without causing harm, The National Psoriasis Foundation (NPF) of America suggests that you should always wear factor 30 or above in the sun, while Dr Michele Henry MD of SunsolveMD recommends SPF 50 plus at all times.

Those with psoriasis should look out for these factors beyond a high factor:

• “Broad-spectrum” labelled sunscreen, meaning it offers protection from both UVA and UVB rays
• Water resistant, so that the SPF stays on your body to protect you, and also to avoid polluting the ocean and damaging coral reefs (SunsolveMD products are certified reef safe)
• Mineral-based SPF, meaning they contain mineral based ingredients such as titanium dioxide or zinc oxide. This is because some chemicals in generic sunscreens can irritate the skin or trigger flares.
• Hypoallergenic or designed for sensitive skin (ideally fragrance-free) so as not to incur further irritation or burn

Which Sunsolve products work for those with psoriasis?

As well as offering the above, SunsolveMD products are inert, meaning they do not react with the skin – an excellent option for those with sensitive skin or skin conditions. Examples of SunsolveMD sunscreens that can be used by those experiencing psoriasis include:

• SunsolveMD Calming Mineral Serum SP50, which is formulated with SunsolveMD’s anti-redness complex, this nourishing, rich mineral SPF formula visibly corrects the look of skin redness and offers a calming, restorative effect to the skin.
• SunsolveMD CeraPol-3 Technology TM: Patented Targeted anti-inflammation technology designed to soothe the skin's barrier at the lipid level.
• SunsolveMDSolveDNAReverseTM: Reversing DNA photo sun damage powered by a complex repair enzyme.

These chemical-free sunscreens are specifically designed for the beach because they utilise brand new, environmentally compatible non-nano zinc oxide material to be reef safe, protecting aquatic life when you enter the water.

Experts advise applying sunscreen every one to two hours, especially after sweating or swimming and especially at the beach and especially in heightened hours of sunlight. Medical experts also add that it is best not to apply sunscreen to actively inflamed or open skin.

How to treat sunburn or irritation if it does occur

Should sunburn occur, there are several ways to soothe the pain that are safe for those with psoriasis; a cool path with oatmeal, application of soy moisturiser or aloe vera, drink plenty of water to prevent dehydration, do not scratch, burst or irritate skin blisters, take aspirin or ibuprofen to reduce pain and swelling, cover up when outdoors with clothing and factor 50 where possible, and avoid further exposure to sunlight.

Key takeaways

Overall then, while there is currently no cure for psoriasis, sunshine can be a highly beneficial treatment when it comes to psoriasis. Yet sun exposure brings the risk of sunburn which can aggravate the skin more, as well as long-term damage. The right SPF is essential for preventing burn, long-term damage or irritation through gradual exposure to natural sunlight.

References

Søyland E, Heier I, Rodríguez-Gallego C, Mollnes TE, Johansen FE, Holven KB, Halvorsen B, Aukrust P, Jahnsen FL, de la Rosa Carrillo D, Krogstad AL, Nenseter MS. Sun exposure induces rapid immunological changes in skin and peripheral blood in patients with psoriasis. Br J Dermatol. 2011 Feb;164(2):344-55. doi: 10.1111/j.1365-2133.2010.10149.x. PMID: 21271993. https://pubmed.ncbi.nlm.nih.gov/21271993/ (https://pubmed.ncbi.nlm.nih.gov/21271993/)

Li Y, Cao Z, Guo J, Li Q, Zhu W, Kuang Y, Chen X. Assessment of efficacy and safety of UV-based therapy for psoriasis: a network meta-analysis of randomized controlled trials. Ann Med. 2022 Dec;54(1):159-169. doi: 10.1080/07853890.2021.2022187. PMID: 34989291; PMCID: PMC8741237.

Barrea L, Savanelli MC, Di Somma C, Napolitano M, Megna M, Colao A, Savastano S. Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist. Rev EndocrMetabDisord. 2017 Jun;18(2):195-205. doi: 10.1007/s11154-017-9411-6. PMID: 28176237; PMCID: PMC5486909. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486909 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486909)

Butrón-Bris B, Daudén E, Rodríguez-Jiménez P. Psoriasis Therapy and Skin Cancer: A Review. Life (Basel). 2021 Oct 19;11(10):1109. doi: 10.3390/life11101109. PMID: 34685480; PMCID: PMC8538945. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8538945/ (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8538945/)

Medical News, 2018,https://www.medicalnewstoday.com/articles/306838